In this section you are going to define AAC and related terms in more detail. Take time to explain what AAC is, what it includes and how it can be integrated with other assistive technology. This is an important consideration when creating an AAC policy. Educational settings are expected to identify the need for AAC and support the implementation of its use. It is likely that this will be done under the guidance of the learners’ Speech and Language Therapist.
Should we include photos of pupils to illustrate points?
All the schools involved in creation of this guide stated that embedded pictures and images were helpful.
Photos of your learners using different forms of AAC can be helpful to family, carers and external agencies who are new to AAC as it is unlikely that they have ever seen the items before or have seen them but do not know what they are called. If you decide to include photos, it can be useful to audit your existing image library and decide if there are more illustrations you need to capture. It is also essential to gain parental consent before publishing images of learners in your AAC policy.
Below are some examples of definitions of AAC and elements that it includes which you may wish to add to your policy.
Augmentative and Alternative Communication (AAC) refers to any means by which an individual can supplement or replace spoken communication. Communication may range from any movement or behaviour that is observed and interpreted by another person as meaningful, to the use of a code agreed upon between people where items have specific meanings, i.e. a language. We all use some form of augmentative communication in our daily life, for example, gesture (waving goodbye) and graphic symbols (washing label symbols, road signs).
AAC can be divided into two categories; unaided and aided communication:
Unaided communication can be described as modes of communication that use only the body. These include:
Body language, eye pointing, facial expression, natural gesture, use of vocalisation/intonation, sensory stimulation
Sign languages (eg British Sign Language, American Sign Language)
Signing systems (eg Paget-Gorman Signed Speech, finger spelling)
Signed vocabularies (eg Sign Supported English, Makaton vocabulary, Signalong)
Verbal/gestural strategies used to compensate for poor speech (eg cued articulation, cued speech)
Aided communication can be described as modes of communication that require equipment in addition to the communicator’s body. These include:
Objects or photographs, pictures, graphic symbols eg: Widgit and Picture Communication Symbols and words, which may be organised into paper-based charts or books.
Communication aids which produce speech and/or text, more commonly called VOCAs (Voice Output Communication Aids). VOCAs are dedicated hardware units or computers, tablets or iPads with communication software / apps. They may produce a digitised voice (from voice recordings) or a synthesised voice.
Aided communication systems require a reliable method of access:
Pointing to items
Eye pointing
Use of a keyboard
Use of an infra-red or light pointer
Use of scanning with an input device such as a switch
Use of a pointer control system such as a joystick or tracker ball
Use of listener-mediated scanning (in which the communication partner assists the user to make vocabulary selections)
Integrating AAC systems with other assistive technology can be useful to consider and something which many families, carers and professionals do not know is possible. Integration can lead to less equipment doing more functions. For AAC to be effective learners need to have a toolkit of communication strategies to express themselves in various environments and when technology breaks or fails. There are also issues of the perceived status of low- and high-tech communication systems. High-tech systems (e.g. VOCAs) are often seen as having higher status than a communication chart or book, but in fact both low- and high-tech systems of communication are essential. In recent years, this has been phrased as paper-based and electronic systems to highlight the equality and importance of both systems. Electronic is not necessarily better than paper based, the need and use of both will be unique to a learner’s needs and preference.
Is everyone aware of what we mean by integration?
It could be a good opportunity for the team to go away and look into this more. Occupational Therapists, ICT/AT professionals, wheelchair services and AAC device suppliers can be a good source of information about the possibilities.
Below are some examples of integration and effectiveness which you may wish to include in your policy.
AAC systems may be integrated with other systems. They could be linked to mobility systems e.g. a learner's powered wheelchair, classroom or personal computers, printers and environmental control systems.
To be effective, all AAC users will need to be taught to use more than one mode of communication according to their individual needs and abilities. Even an able user of a sophisticated VOCA (voice output communication aid) will also require simple aided and unaided systems. For example, a VOCA cannot be used in a swimming pool, but you can use a communication chart on a float.
Using a variety of modes of communication, including speech, can be referred to as total communication. The learner’s social and learning environment should facilitate and encourage the use of total communication.
Noah has Cerebral Palsy affecting his fine and gross motor skills in all four limbs, impacting on his ability to access a computer. Noah enjoys school and wants to be as independent as possible in recording his work. Noah controls his powered chair with a joystick.
During an Ace Centre assessment in which Noah explored ways to access education, he trialed a range of technology and access methods including eyegaze, voice control, external joysticks and keyboards. These methods were effortful for Noah and often impacted upon his seating posture.
Noah’s most accurate and efficient means of access was using his wheelchair joystick. Noah was familiar with the pressure and the position was optimal as it allowed him to rest his arm in a comfortable position.
Therefore, Noah was provided with an integrated bluetooth joystick. This joystick replaced his original one and was set up to drive his wheelchair, connect to his phone and his windows school computer. Noah uses a button on the joystick to choose the mode i.e. what item he is controlling. This meant he could use one joystick to control multiple devices.